Background: The health sector reform in Colombia had a deep effect on public health programmes. Changes on organizative structure and intervention activities for Tuberculosis control (TBC), have been caused by the emergence of new actors involved in health services delivery; design of new health plans; responsibilities diversification and their vagueness; and system decentralisation.
Objective: Known perceptions of key actors of TBC control about effects generated by Colombian Health Sector Reform implementation.
Methods: A qualitative case study was carried out. Information was obtained through semi-structured interviews. In total, 15 key health officials responsable for tuberculosis control at national, state and local level were interviewed.
Results: The most relevant negative effects of the implementation of Health Sector Reform on TBC control programme were: lack of political will; corruption in resources management; poor managerial and technical skills; deficiency in government supervision activities at local level; inadequacy of the government fulfilment of its administrative and financial obligations. Diversification of financial resources was pointed out as a facilitating factor, because of the increased allocation of resources for programme control.
Discussion: A perceived reduction of the regulative and control role of the government in the operation of the Health System and on the TBC was the main finding of the study. Introduction of new actors on health services delivery and the increased resource allocation to TBC control did not produce the expected positive effects, and quantity and quality of tuberculosis actions were reduced.